Ticket for Outdoor Patient
| Ward No. 14 | U-PHC No. | Registration No. 03186 | Date 15/10/2019 |
| Token No | SM/22-23/4178 29/07/2022 | Serial | 007 |
| Patient Name | Mrs. RINKU DEBI | Contact No | 8981944375 |
| Address | 79/A DEY STREET | Age | 30 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||